Catheter & Accessories Formulary 2018 · 2018-02-12 · NHS Fife Catheter & Accessories Formulary...

Catheter & Accessories Formulary 2018

Reference guide for the Prescribing & PECOS ordering of all Indwelling Catheters & Drainage Bags & Accessories

Reviewed: January 2018

For Review: January 2021

NHS Fife Catheter & Accessories Formulary 2018

2

CONTENTS

INDEX PAGE

Introduction 3

Prescribing Quantities & Tips 4

SECTION ONE – PRESCRIBING INFORMATION

Indwelling Catheters and Urinary Sheaths 5

Leg Bags 6

Overnight/2litre bags 7

Fixation Device 7

Bag Holder 7

Catheter Valve 8

Catheter Maintenance Solutions 8

Anaesthetic Gel 8

Nephrostomy Drainage Bags 8

Appendix 1 – Exception Form 13

SECTION TWO - PECOS ONLINE ORDERING

Introduction 9

Indwelling Catheters 10

Leg Bags 11

Drainage Bags 11

Urinary Sheaths 11

Fixation Device 12

Bag Holder 12

Catheter Valve 12

Catheter Maintenance Solutions 12

Anaesthetic Gel 12

Nephrostomy Drainage Bags 12

Helpful hint 13

Appendix 1 – Exception Form 14

The information contained within this booklet is intended for use by healthcare professionals within NHS

Fife. At the time of going to print all prices were taken from the Dec 2017 Scottish Drug Tariff & the PECOS

online ordering catalogue.


3

INTRODUCTION

Continence Formulary

This formulary is a joint guide for all healthcare professionals that prescribe/request

prescriptions or order through PECOS for patients that require products for bladder

dysfunction.

This booklet has been designed as a quick reference guide for first line choices which should

be used for all new patients and for current patients when a re-assessment of their needs is

completed.

The formulary will be reviewed on a regular basis and at this point any amendments or

additions will be considered. Wherever possible there is a continuity of product use between

primary and secondary care which has been achieved by joint working on this formulary.

If you are unable to prescribe or order a FIRST CHOICE PRODUCT the ‘EXCEPTION FORM’

should be completed with reasons for use of non-formulary products (Appendix 1) or

alternatively contact the Continence Advisor / Senior Prescribing Support Nurse (SPSN) Team

for details of a second choice product.

This reference guide has been split into 2 sections:-

Section One – For healthcare staff prescribing or requesting a prescription.

Section Two – For healthcare staff ordering through PECOS using the Non Prescription

Ordering (NPO) system.

This formulary is authorised by Pauline Millar Continence Advisor for NHS Fife, with

contribution from the Senior Prescribing Support Nursing Team, Mary Thomson & Karen

Whatton.

If you need further information please contact:

Continence Service: 01592 869924 Mary Thomson & Karen Whatton: Fife [email protected] 01592 643355 ext: 22068

mailto:Fife%[email protected]


4

PRESCRIBING QUANTITIES ADVICE

This chart is for guidance purposes only

AVERAGE 56 day cycle/2 monthly PRESCRIBING QUANTITIES

PRODUCT QUANTITY

Leg bags 8 1 x 10 box

Non sterile single use overnight bags 56 6 x 10 packs

Catheter valves 8 2 x 5 packs

Urinary sheaths 28 1 x 30 pack

AVERAGE ANNUAL PRESCRIBING QUANTITY

PRODUCT QUANTITY

Long term catheter 6

Bag Holder/Sleeves ( washable & reusable ) 2 x 4 packs

G Strap Adult 2 x 5 packs

PRESCRIBING TIPS

1. LONG TERM INDWELLING CATHETERS - 2 catheters should be ordered on the first prescription - so that a spare catheter can be kept in the house/care home. Re-order 1 at a time thereafter.

2. SILVER COATED CATHETERS- Should only be prescribed on the advice of the Continence

Advisor.

DO NOT PRESCRIBE – These are very expensive items and not necessary

Bard Bio-Cath Comprehensive Care Foley Tray Bard Bardex IC Tray Bard Lubrisil Comprehensive Care Foley Tray Cath-It Insertion/Removal Kit Clinisupplies Prosys Cath Trays VESCPO1 and VESCPO2 ORDER THROUGH PECOS:

192762 Catheterisation Pack Each £0.57


5

INDWELLING CATHETERS

PRESCRIBING TIP - When prescribing catheter, add size required to end of code

E.g. CODE = DP3201, Size = 12ch, Prescribing Code = DP320112.

NB. These catheters are also suitable for Suprapubic use.

FIRST CHOICE

LONG TERM CATHETER - UP to 12 WEEKS - HYDROGEL

TYPE RUSCH - AquaFlate SympaCath (Teleflex Medical)

DESCRIPTION Hydrogel Coated Latex SIZE/CH 12- 18

LENGTH Standard Female

CODE DH3101 DH2101

QUANTITY Each COST £6.22

COMMENTS Includes syringe pre-filled with sterile water & empty 10ml syringe for balloon deflation

FIRST CHOICE

LONG TERM CATHETER - UP to 12 WEEKS - SILICONE

TYPE RUSCH - AquaFlate Brilliant (Teleflex Medical)

DESCRIPTION Silicone SIZE/CH 12- 18


CODE DA3101 DA2101



SHEATHS FIRST CHOICE

SILICONE PENILE SHEATHS – SELF ADHERING

TYPE MACGREGOR HEALTHCARE LTD, QUFORA

SIZE 24mm 28mm 31mm 35mm 40mm

CODE (standard length) 20111101 20111201 20111301 20111401 20111501

CODE (short length) 20111103 20111203 20111303 20111403 20111503

QUANTITY 30 30 30 30 30

COST 38.38 38.38 38.38 38.38 38.38

COMMENTS Sheaths should be changed daily. Use Qufora leg bags and overnight bags

FIRST CHOICE

SHORT /MEDIUM TERM CATHETER - UP to 28 DAYS

TYPE RUSCH - AquaFlate PTFE (Teleflex Medical)

DESCRIPTION PTFE Coated Latex SIZE/CH 12- 18


CODE DP3101 DP2101




6

LEG BAGS Included in pack are gloves and elasticated straps. Bags should be changed every 7 days

FIRST CHOICE

LEG BAGS - 350mls

TYPE UNOMEDICAL CARELINE

TAP T TAP

TUBE LENGTH Short Long

CODE 45-01 SVCG 45-02 LVCG

QUANTITY 10 10

COST £25.69 £25.69

LEG BAGS - 500mls


TAP T TAP LEVER TAP

TUBE LENGTH Short Long Short Long

CODE 45-05 SVCG 45-06 LVCG 46-05 SVCG 46-06 LVCG

QUANTITY 10 10 10 10

COST £25.48 £25.48 £25.48 £25.48

LEG BAGS - 750mls


TAP T TAP LEVER TAP

TUBE LENGTH Short Long Short Long

CODE 45-09 SVCG 45-10 LVCG 46-09 SVCG 46-10 LVCG

QUANTITY 10 10 10 10

COST £25.48 £25.48 £26.93 £26.93

COMMENTS

LEG BAGS FOR SHEATHS FIRST CHOICE -

TYPE MACGREGOR HEALTHCARE QUFORA STERILE


CODE 12161804 12161504

QUANTITY 10 10

COST £22.40 £22.40


7

DRAINAGE BAGS FIRST CHOICE

SINGLE USE 2litre OVERNIGHT DRAINAGE BAG

TYPE UNOMEDICAL CARELINE with NON RETURN VALVE-NRV (E2)

CODE 45-40 LBC

QUANTITY 10 per pack COST £2.47

COMMENTS 1 Bag change per night

FIRST CHOICE

STERILE 2litre DRAINAGE BAG - DRAINABLE

TYPE UNOMEDICAL CARELINE T-TAP with NRV (E4)

CODE 45-20-IDC


COMMENTS Bag change every 7 days

DRAINAGE BAGS FOR SHEATHS FIRST CHOICE

TYPE MACGREGOR HEALTHCARE QUFORA Non sterile/Non Drainable

CODE 13800101



FIXATION DEVICE FIRST CHOICE

FIXATION /RETION DEVICE

TYPE COLOPLAST CATHETER RETAINING SIMPLA G STRAP ADULT

CODE 383001


COMMENTS Can be washed and reused

BAG HOLDER/SLEEVE FIRST CHOICE

LEG BAG HOLDERS – REUSABLE/WASHABLE

TYPE PROSYS

SIZE Small/24-40cms Medium/36-50cms Large/40-65cms

CODE PLS3881 PLS3904 PLS3928

QUANTITY 4 per pack 4 per pack 4 per pack

Cost £7.55 £7.55 £7.55

COMMENTS Can be washed and reused for 3-6 months


8

CATHETER VALVE FIRST CHOICE

STERILE CATHETER VALVE FOR USE WITH INDWELLING CATHETER

TYPE PROSYS

CODE PCV3942


COMMENTS Valves should be changed every 7 days

CATHETER MAINTENANCE SOLUTION FIRST CHOICE

CATHETER MAINTENANCE SOLUTION

TYPE BARD OPTIFLO

SOLUTION OPTIFLO S - 0.9% NaCl

OPTIFLO G -3.23% Citric Acid

OPTIFLO R-6% Citric Acid

CODE CSS50 CSG50 CSR50

QUANTITY 50mls 50mls 50mls

each each each

COST £3.39 £3.60 £3.60

COMMENTS Only use where clinically indicated and supported by local standard operating procedures

ANAESTHETIC GEL

FIRST CHOICE

ANAESTHETIC ANTISEPTIC LUBRICANT

TYPE CLINIMED INSTILLAGEL

VOLUME 6mls 11mls

QUANTITY 10 per pack 10 per pack

COST £14.05 £15.76

COMMENTS Contains lidnocaine and lubricant, takes 5 minutes to take effect

NEPHROSTOMY DRAINAGE BAG

FIRST CHOICE

500mls STERILE DRAINAGE BAG

TYPE MANFRED SAUER UK Ltd- NephSys System

TAP TWIST LEVER

CODE NS721.3730S NS721.3730SE

SIZE 30 cm tube 30 cm tube


COST £42.03 £42.43

COMMENTS Bag change every 5 - 7 days


9

SECTION TWO

PECOS ORDERING

This section provides healthcare staff with the codes to place their weekly order through the

PECOS ordering system.

For use by staff who are ordering stock/stores through the

Non Prescribing Ordering (NPO) system.

PLEASE NOTE:

Not all products that are available for prescribing are available through the PECOS online

ordering system. There may be a slight variation from products that are ordered through

PECOS compared to prescription.


10

INDWELLING CATHETERS – PECOS ORDERING

FIRST CHOICE

LONG TERM CATHETER - UP to 12 WEEKS - HYDROGEL

TYPE RUSCH - AquaFlate SympaCath

DESCRIPTION Hydrogel Coated Latex SIZE/CH 12- 18


CODE/SIZE 003587 12 003549 12

003594 14 003556 14

003600 16 003563 16

003334 18



FIRST CHOICE

LONG TERM CATHETER - UP to 12 WEEKS -SILICONE

TYPE RUSCH - AquaFlate Brilliant

DESCRIPTION Silicone SIZE/CH 12- 18


CODE/SIZE 078646 12 018369 12

080236 14 018376 14

018338 16 018383 16

018345 18

018352 20



FIRST CHOICE

SHORT /MEDIUM TERM CATHETER - UP to 28 DAYS

TYPE RUSCH – PTFE Coated

DESCRIPTION PTFE Coated latex SIZE/CH 12- 18


CODE/SIZE 003419 12 003327 12

003518 14 003501 14

003341 16 003389 16

003525 18 031146 18




11

LEG BAGS – PECOS ORDERING

FIRST CHOICE

LEG BAGS - 500mls


TAP LEVER TAP


CODE 220830 220823

QUANTITY Each Each

£0.25 £0.25

COMMENTS Bag should be changed every 7 days

FIRST CHOICE

SINGLE USE 2litre NIGHT DRAINAGE BAG

TYPE UNOMEDICAL CARELINE with NON RETURN VALVE-NRV

CODE 136902



DRAINAGE BAGS – PECOS ORDERING

FIRST CHOICE

STERILE 2litre DRAINAGE BAG - DRAINABLE

TYPE UNOMEDICAL CARELINE T-TAP with NRV

CODE 201266


COMMENTS Bag change every 7 days

URINARY SHEATHS –PECOS ORDERING

FIRST CHOICE

SILICONE PENILE SHEATHS – SELF ADHERING

TYPE CONVEEN OPTIMA SILICONE

SIZE 21mm (shorter length) 25mm 30mm 35mm

CODE 195855 116522 116539 116546

QUANTITY 5 5 5 5

COST £2.50 £2.50 £2.50 £2.50

COMMENTS Sheaths should be changed daily


12

FIXATION DEVICE – PECOS ORDERING

FIRST CHOICE

FIXATION /RETION DEVICE

TYPE COLOPLAST CATHETER RETAINING G STRAP ADULT

CODE 099573


COMMENTS Can be washed and reused

BAG HOLDER/SLEEVE – PECOS ORDERING

FIRST CHOICE

LEG BAG HOLDERS – REUSABLE/WASHABLE

TYPE UNOMEDICAL

SIZE Small Medium Large

CODE 126385 126378 126361

QUANTITY 4 per pack 4/per pack 4/per pack

COST £4.21 £4.40 £5.28

COMMENTS Can be washed and reused for 3-6 months

CATHETER VALVE – PECOS ORDERING

FIRST CHOICE

STERILE CATHETER VALVE FOR USE WITH INDWELLING CATHETER

TYPE UNOMEDICAL

CODE 181636


COMMENTS Valves should be changed every 7 days

CATHETER MAINTENANCE SOLUTION ANAESTHETIC LUBRICATING GEL See Section 1 – This still requires to be ordered on prescription. (See pages 8+9)

NEPHROSTOMY DRAINGE BAG- PECOS ORDERING

FIRST CHOICE

500mls STERILE DRAINAGE BAG

TYPE MANFRED SAUER UK Ltd- NephSys System

TAP TWIST LEVER

CODE NS721.3730S NS721.3730SE

SIZE 30 cm tube 30 cm tube


COST £42.43 £42.43

COMMENTS Bag change every 5 - 7 days


13

USEFUL HINT ON ATTACHING DRAINAGE BAG TO SILICONE CATHETER

To maintain the life of the

catheter by preventing

stretching, insert the leg bag

so there are still 2 or 3

notches visible


14

NHS FIFE PRODUCT REQUEST AND EXCEPTION FORM

Please complete Part A for all Non Formulary Requests.

Please complete Part B for wound care and/or Part C for catheter care products.

PART A

Person Requesting: Job Title: Work Base: Date of Request: NAME OF NON-FORMULARY PRODUCT

PRODUCT SIZE QUANTITY REQUIRED

PART B - WOUND

Type of wound: Size of wound:

Location of Wound: Level of Exudate: Duration of Wound:

Formulary products already tried: Reason formulary product not suitable:

PART C - CATHETER

Suprapubic/Urethral:

Formulary Product already tried: For how long?

Reason formulary product not suitable:

Discussed with specialist: Yes/No □TVN □Continence Advisor □Vascular □Podiatrist □Plastics □Other

Name of Specialist:

NON FORMULARY PRODUCT REVIEW DATE

Once completed please send to Senior Prescribing Support Nurse Team

[email protected] or Cedar House, Whytemans Brae, Kirkcaldy

Completing this form will enable the SPSN to collate non formulary prescribing information and therefore inform

future discussions on formularies, training etc.

Copies can be obtained from: http://www.fifeadtc.scot.nhs.uk/formulary/woundcare-formulary/woundcare-

catheter-product-request-and-exception-form.aspx

Appendix 1

mailto:[email protected]

http://www.fifeadtc.scot.nhs.uk/formulary/woundcare-formulary/woundcare-catheter-product-request-and-exception-form.aspx

http://www.fifeadtc.scot.nhs.uk/formulary/woundcare-formulary/woundcare-catheter-product-request-and-exception-form.aspx

Catheter & Accessories Formulary 2018 · 2018-02-12 · NHS Fife Catheter & Accessories Formulary...

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